Parent or Guardian Consent Form

The bill, which is effective as of September 1, 2025, requires annual parental consent for the following:

  • Health Services: This includes routine physical and mental health services provided by a school nurse or other staff. This can range from a nurse putting a bandage on a minor cut to vision and hearing screenings and even initial assessments during an illness at school.

  • Counseling: Parents must consent for their child to receive short-term school-based counseling for emotional or behavioral support. This also includes in class guidance and character building activities and lessons.   Academic counseling, however, does not require parental consent.

  • Student Clubs: Written parental consent is now mandatory for a student to participate in any school-sponsored club, organization, or extracurricular activity.

If parents do not provide consent, the school can only provide services in a life-threatening emergency.

Email *
Date:  *
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Student Name: *
Student Campus *
Student Grade Level *
Parent/Guardian Opt-in Permission for Health-Related Services (Nurse) *
Parent/Guardian Opt-in Permission for Counseling-Related Services *
Parent/Guardian Opt-in Permission for Student Clubs.  Examples of student Clubs include, but are not limited to:  
Future Farmers of America (FFA)

Health Occupations Students of America (HOSA)

Student Council

Robotics Club

National Honor Society

 *
By typing my name below, I confirm that:
● I am the parent or guardian of the student named in this form.
● The Yes/No answers I gave in this form show what I want for my child’s school health services, counseling, and student clubs.
● I understand the signature below will count as my signature for those choices.
 *
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